Objective:

To determine whether ethnicity or age influences post-treatment changes in corneal curvature and thickness following corneal cross-linking (CXL) for keratoconus.

Key Findings:

• CXL outcomes were broadly comparable between UK and Saudi cohorts despite differences in baseline disease severity.
• Over 80% of eyes in both groups stabilized or improved at three years post-CXL.
• Mean Kmax improved by approximately 1.3 D in the UK cohort and 1.2 D in the Saudi cohort, both statistically significant.
• Significant improvements in corneal curvature were observed across all age groups in the Saudi cohort.
• No age group demonstrated a clearly superior response to treatment.

Interpretation:

Neither ethnicity nor age significantly alters the effectiveness of CXL in halting keratoconus progression; baseline disease severity is a more prominent factor.

Limitations:

• Further research is needed to refine patient selection and timing for CXL treatment.

Conclusion:

CXL is a reliable intervention across diverse patient groups, supporting treatment without delay based on age or demographic factors.